Ten percent of the world’s children aren’t meeting basic global vaccination standards. New data from the World Health Organization (WHO) and UNICEF estimates that in 2016, nearly 12.9 million infants did not receive any vaccinations. This includes the first dose of the DTP vaccine, which is considered to be an essential vaccination for children.

DTP is the three-round vaccination that protects against diphtheria, tetanus, and pertussis, commonly known as whooping cough. According to a release from WHO and UNICEF, this immunization is “one of the most successful and cost-effective public health interventions,” preventing 2-3 million deaths annually.

The data shows that in 130 of 194 WHO member states, at least 90 percent of infants received their full course of vaccinations at the national level. Additionally, 6.6 million infants failed to complete all three doses of the DTP immunization series after receiving their first dose.

Jean-Marie Okwo-Bele, director of immunization, vaccines and biologicals at WHO, said in the release that lack of vaccination can indicate overall health of children in a region.

“These children most likely have also not received any of the other basic health services,” Okwo-Bele said. “If we are to raise the bar on global immunization coverage, health services must reach the unreached. Every contact with the health system must be seen as an opportunity to immunize.”

Getting to 90 Percent

While 86 percent of children received their routine vaccinations in 2016, WHO’s goal is to vaccinate 90 percent of children globally. The number has remained at about 86 percent since 2010, and the new data shows there has not been any improvement in the last year.

This 90 percent coverage target is part of the agency’s Global Vaccine Action Plan, which was endorsed in May 2012 by WHO member states. To meet this goal, WHO says, “an estimated 10 million additional infants need to be vaccinated in 64 countries, if all countries are to achieve at least 90% coverage.”

Immunization Barriers

Vaccinating these additional 10 million children has proven difficult due to politics and location. Eight countries failed to vaccinate at least 50 percent of their infants against DTP. Most of these nations are war-torn countries like South Sudan and Syria, where conflict has resulted in the destruction of hospitals and health centers, making it difficult for vaccinations to reach many areas.

Unsurprisingly, poverty was also shown to impact how well a country’s children were vaccinated. According to the data, poor, urban populations are most at-risk of being under-immunized. This is a global problem, but particularly in “rapidly growing slums in Africa and Asia,” the release reads.

Robin Nandy, chief of immunizations at UNICEF, said in the release that immunization is “one of the most pro-equity” public health interventions.

“Bringing life-saving vaccines to the poorest communities, women and children must be considered a top priority in all contexts,” Nandy said.

Still, foreign aid and other factors have given some nations the ability to break through the poverty obstacle. Okwo-Bele told NPR that poor countries, like Tanzania, have improved their DTP vaccination rates because of their prioritization of immunizations as a national issue.

“[Tanzania] has had the political will to make immunizations a priority, and with foreign health aid, has built a well-organized system to deliver vaccines where needed, with trusted community health workers and reliable refrigeration for vaccines,” according to NPR.

UNICEF and WHO are continuing to research the impact of economic inequality on vaccination.

Avery Anapol

Avery Anapol is a blogger and freelancer for Law Street Media. She holds a BA in journalism and mass communication from the George Washington University. When she’s not writing, Avery enjoys traveling, reading fiction, cooking, and waking up early. Contact Avery at Staff@LawStreetMedia.com.

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A landmark bill was just passed in California which will make vaccinations necessary for all students, unless they have a medical exemption or the parents choose to homeschool their children. This law eliminates the personal and religious belief exemptions completely, and was met with overwhelming praise, although not without protest. It has been the subject of heated debate for the past few months, although it was finally approved last Tuesday. The Golden State has been forced to take extra precautions after a measles outbreak at Disneyland wreaked havoc on the public, leaving over a hundred people infected.

California Legislature passes mandatory public school vaccination bill #SB277 http://t.co/Rpt3bJvNPI pic.twitter.com/wepXmF011C

— Los Angeles Times (@latimes) June 29, 2015

The bill passed with bipartisan support in the Assembly before it was sent to California Governor Jerry Brown, who hastily signed it, enabling it to finally become a law. Politicians have mixed views on this topic, although it seems that the consensus is that vaccinations are necessary to protect the health of the general public. Recent events have caused numerous bills to be proposed throughout the country, although California’s is one of the first to be set in motion.

Two other states, West Virginia and Mississippi, have already imposed similar laws, and they have proven to very successful so far. California made a wise decision in following the lead of its southern counterparts and given how prominent a state California is, it will likely be a model for other states to follow if all goes well. Many states seem to be interested in implementing similar legislation, and so all eyes will be on California to see just how such actions impact its citizens.

This preventative measure is aimed at schools–both public and private institutions–as well as day care centers. This law also creates clear guidelines for future requirements regarding vaccines so that there are no questions of procedure or exemption. There will now be two vaccination checkpoints for children, one at the kindergarten level, and one in seventh grade. A grandfather clause was also created, which will allow children to wait until the next checkpoint to be vaccinated if they missed the first one due to a personal belief exemption before this change was instituted.

The subject of vaccination has proven to be a very contentious topic in the United States in recent years. But what’s most important is the science behind this decision, and the experts believe that this law is imperative for preventing future outbreaks. Pediatricians in California have high hopes for this new policy, announcing their beliefs that it will most likely increase immunization rates and stop diseases from spreading. The goal is to protect the masses, not only children, but entire communities. So long as the vast majority of people are vaccinated, then the chances of another outbreak are astronomically low. Research has proven that such stringent rules help to create safer environments, so why do so many still have a problem with vaccines?

While the reasons for the opposition to vaccines do merit some recognition, since there is always the microscopic chance of complications, it is obvious that the pros far outweigh the cons in this situation. Many people believe that they can cause disorders such as autism, despite most research debunking this theory. Most other objections are due to personal or religious reasons. Parents used to be able to simply check a box to decide whether or not to inoculate solely based on their beliefs. While this law makes vaccinations mandatory for the majority, there will still be a few opportunities for exemptions. If parents completely refuse to vaccinate their children, then they must pledge to homeschool their children. Medical exemptions will still be available to those with serious health conditions, although this decision will be left up to the professionals. It was also announced that an amendment might be added to the law, and if passed, would make it so that doctors can use family medical histories of patients when evaluating children for medical exemptions.

Actor Jim Carrey made headlines for speaking out in disgust against the new law, even going so far as to call Brown a fascist. In his infamous Twitter rant, he accused the California legislature of being corrupt and knowingly poisoning children by requiring vaccinations. Carrey is only one of many to voice his furor, although it seems that there are far more supporters than protestors for this law.

Numerous groups have also announced their opposition, including the California ProLife Council, California Nurses for Ethical Standards, and the National Vaccine Information Center. Angry parents joined these groups in posting on social media to express their outrage. There have been many disputes between parents regarding this new legislation, and thousands have even stormed the capitol in protest. One major argument that protestors use against this law is that it takes away a parent’s ability to control what goes into their children’s bodies.

No one died during the measles outbreak at Disneyland, although it was still extremely scary for everyone involved and brought much unwanted attention to California. Disneyland is a major tourist destination that attracts millions of visitors a year, and so such a powerful disease infiltrating this popular institution seemed shocking at the time. Such an outbreak in California was upsetting to many after the disease was supposedly eradicated years ago. This was only the latest event in American history to trigger a national debate on the necessity of vaccines. There was also a recent outbreak of whooping cough in a Los Angeles school district where 90 students were infected, although experts believe that this incident could have been prevented. Officials of this district are praising this new law, as they believe that it will definitely help combat future outbreaks.

This law will not take effect until July of 2016, so those who are unhappy have time to move to another state. Some parents find it to be too drastic and have said that they will sue school districts just to get their child admitted without being vaccinated, although it does not seem that they will be triumphant. This law would mandate the entire state to follow through with the law, with very few exceptions. The hope is that given all of the research and findings associated with the benefits of vaccinations, parents will open their minds to the possibility of vaccines benefiting the public.

Toni Keddell

Toni Keddell is a member of the University of Maryland Class of 2017 and a Law Street Media Fellow for the Summer of 2015. Contact Toni at staff@LawStreetMedia.com.

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It was probably only a matter of time, but vaccination has officially become a political issue. The particular hot topic at the moment is the vaccination of measles. Despite the fact that the virus had been declared “eliminated” from the United States in 2000, there have been approximately 100 cases recently stemming from outbreaks at Disney theme parks–particularly Disneyland in California. Public health officials are encouraging parents to make sure that their children get vaccinated. But that doesn’t mean that it’s not becoming a political conversation–while some politicians like President Barack Obama have encouraged parents to get their children vaccinated, others, like New Jersey Governor Chris Christie have continued to emphasize that it’s an individual choice to be made by parents.

There are plenty of reasons why children don’t get vaccinated–for an in-depth look, check out our issues brief on the topic–but at the most simplistic level, they can get sorted into two camps. The first group are children whose parents choose not to vaccinate them, whether it be because of religious beliefs, concerns about the side effects of vaccines, or whatever other personal reason. The other group is children who physically can’t be vaccinated, usually because they have some sort of allergy to the vaccines, or some illness or condition that would it make it unsafe to be vaccinated. This also includes children who are too young to receive the vaccine–although that’s obviously only a temporary situation. Basically since the measles vaccine became mainstream, those who actually can’t be vaccinated are protected, because those around them can’t get or spread the disease. Unfortunately, as fewer people are vaccinated, that becomes less true, and the spread of measles becomes a legitimate concern.

That being said, it’s not illegal to not vaccinate your child in most places–some states, such as California, are pretty generous when it comes to granting exceptions. Particularly under fire right now are the loopholes that California allows when it comes to its exemption laws, which do require that parents wishing to forego the vaccines undergo “counseling” and get signatures from healthcare professionals. According to Mercury News, those parameters aren’t actually that strict, because:

Counseling can be given by naturopaths, who practice alternative medicine and typically oppose vaccination.

In addition:

People who oppose vaccination because of religious beliefs can skip counseling, a policy change that Gov. Jerry Brown instituted when he signed the updated law.

This has led to a concerning number people in California being unvaccinated–in 2014, 2.5 percent of kindergartners had vaccine exemptions. That doesn’t sound like that many out of context, but that’s pretty much one unvaccinated kid for every other classroom. Children and teens who are unvaccinated are being sent home from school, and there’s a real worry that measles could continue to spread among the unvaccinated population, much of which is clustered into specific schools and neighborhoods.

The CDC put out a statement a few days ago urging any Americans who aren’t vaccinated to do so as soon as possible. President Barack Obama echoed the CDC’s comments on the Today show. However, New Jersey Governor Chris Christie came under fire for a statement he made in response that said that the government should “balance” government and parent interests when it comes to vaccines, saying:

Mary Pat and I have had our children vaccinated and we think that it’s an important part of being sure we protect their health and the public health. I also understand that parents need to have some measure of choice in things as well, so that’s the balance that the government has to decide.

Christie has since clarified that statement, releasing a statement as follows:

The Governor believes vaccines are an important public health protection and with a disease like measles there is no question kids should be vaccinated. At the same time different states require different degrees of vaccination, which is why he was calling for balance in which ones government should mandate.

Obviously this is a clear example of a big difference between Democrats and Republicans–a federal approach vs. a more state-based one is certainly open for debate. That being said, it’s important that our elected officials stay strong and and stand together in encouraging all Americans who are able to get vaccinated or vaccinate their children to do so. There’s a time for politics, but now, with this topic, isn’t it.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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